Download Prostate Cancer - Contra Costa Health Services

CHRONIC DISEASES
Prostate Cancer
Prostate cancer was the most commonly diagnosed
cancer among males.
• Most new prostate cancer cases and deaths were among white males.
• Black males were most likely to be diagnosed with prostate cancer.
• African American males were more likely to die from prostate cancer than county men
overall.
Prostate Cancer Deaths
Between 2005–2007, prostate cancer was responsible for 2.7% of all deaths and 10.8% of all cancer
deaths among Contra Costa males. In Contra Costa, 270 males died of prostate cancer. This means
that an average of 90 males in the county died from prostate cancer each year.
Contra Costa’s age-adjusted death rate from prostate cancer was lower than California’s age-adjusted
rate (25.3 per 100,000) and met the Healthy People 2010 objective (28.2 per 100,000).
Table 1  Prostate cancer deaths by race/ethnicity
Contra Costa County, 2005–2007
Deaths
Percent
Rate
201
74.4%
23.7
African American
38
14.1%
53.1*
Hispanic
18
6.7%
NA
Asian/Pacific Islander
11
4.1%
NA
270
100.0%
White
Total
22.7
In this report a
prostate cancer
case is defined
as a primary
malignant tumor
that originated in
the prostate rather
than having spread
from another
location.
These are age-adjusted rates per 100,000 male residents.
Total includes racial/ethnic groups not listed above.
* Significantly higher rate than county males overall.
The greatest number of deaths from prostate cancer in the county occurred among whites (201), followed by African Americans (38), Hispanics (18) and Asians/Pacific Islanders (11). Although African
American males died from prostate cancer in fewer numbers, they had a higher death rate (53.1 per
100,000) from prostate cancer than county males overall (22.7 per 100,000).
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CHRONIC DISEASES
Table 2  Prostate cancer deaths by selected cities
Contra Costa County, 2005–2007
Deaths
Percent
Rate
Walnut Creek
50
18.5%
27.9
Richmond
36
13.3%
35.0
Concord
27
10.0%
23.0
Antioch
17
6.3%
NA
San Pablo
12
4.4%
NA
Pittsburg
12
4.4%
NA
Pleasant Hill
12
4.4%
NA
Martinez
10
3.7%
NA
El Cerrito
10
3.7%
NA
Oakley
9
3.3%
NA
Brentwood
7
2.6%
NA
270
100.0%
Contra Costa
Invasive prostate
cancer is cancer
that has spread
beyond the tissue
where it developed
to surrounding,
healthy tissue.
22.7
These are age-adjusted rates per 100,000 male residents.
Contra Costa total includes males from cities not listed above.
The greatest numbers of deaths from prostate cancer occurred among males living in Walnut Creek
(50), Richmond (36) and Concord (27). The prostate cancer death rates of these three cities were
similar to the county overall rate (22.7 per 100,000). Data at the city level was limited due to small
numbers of deaths.
New Cases
To understand the impact of prostate cancer on the community’s health it is important to assess both
prostate cancer diagnoses and deaths. Information about prostate cancer deaths indicates the ultimate
toll this disease takes on males lives, but many more males develop prostate cancer than die from it.
Information about new prostate cancer cases provides a sense of how much and among whom the
disease is diagnosed and can highlight the need for prevention, screening and treatment programs.
Between 2003–2007, 3,908 new cases of invasive prostate cancer were diagnosed in Contra Costa—an
average of 782 new cases per year. Prostate cancer was the most commonly diagnosed invasive cancer
among males in Contra Costa, accounting for approximately one-third (33.5%) of all new invasive
cancer cases among males. The age-adjusted rate of new invasive prostate cancer cases was higher in
Contra Costa (170.0 per 100,000) than California (146.6 per 100,000).
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CHRONIC DISEASES
The greatest number of new invasive prostate cancer cases in Contra Costa occurred among white males
(2,727) followed by black (405), Hispanic (311) and Asian/Pacific Islander (253) males. Although white
males accounted for most new invasive prostate cancer cases, black males had the highest rate of new
cases (241.5 per 100,000); higher than males in the county overall (170.0 per 100,000) and the other
racial/ethnic groups listed in the table. Asian/Pacific Islander males (91.0 per 100,000) experienced
the lowest rate of new invasive prostate cancer cases in the county. Hispanic males (143.0 per 100,000)
also had a lower rate than males in the county overall.
Table 3  New invasive prostate cancer cases by race/ethnicity
Contra Costa 2003–2007
White
Cases
2,727
Percent
69.8%
Rate
168.3
Black
405
10.4%
241.5*
Hispanic
311
8.0%
143.0**
Asian/Pacific Islander
253
6.5%
91.0**
3,908
100.0%
Total
170.0
These are age-adjusted rates per 100,000 male residents.
Total includes males in racial/ethnic groups not listed above.
* Significantly higher rate than county males overall.
** Significantly lower rate than county males overall.
What is prostate cancer?
The National Cancer Institute defines prostate cancer as “cancer that forms in the tissues of the prostate (a gland in the male reproductive system found below the bladder and in front of the rectum).”1
Why is it important?
Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death
among males in Contra Costa2,3 and the United States.4
Who is most impacted?
In Contra Costa, black/African American males are most likely to be diagnosed with prostate cancer
and are more likely to die from the disease than males in the county overall.2,3 Similar patterns exist
at the national level.5 Although the exact causes of prostate cancer are not known, several factors can
increase the chance of developing prostate cancer: older age;4,6 family history of prostate cancer (i.e.,
brother or father);4,6 and some genetic factors.4 High levels of testosterone and diets high in fat (especially animal fat) may also increase the risk of prostate cancer.6
What can we do about it?
The survival rate for prostate cancer is quite high. The chance of surviving five years after a prostate
cancer diagnosis is 98% for all stages.7 However, five-year survival is 33% if the cancer has spread to
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CHRONIC DISEASES
other parts of the body.7 Most prostate cancers are identified early through screening, using the prostate-specific antigen (PSA) test.4
Because many prostate cancers are slow-growing, they may never become life threatening. Screening
and treatment do provide benefits for some males who develop prostate cancer, but there is uncertainty
about the balance of risk and benefits for the population at large, particularly given the potential side
effects of treatment.4 The American Cancer Society suggests that males with at least a 10-year life expectancy who do not have symptoms of prostate cancer work with their health care provider to make
an informed decision about whether to be screened.4 The age at which males should begin receiving
information about screening varies depending on their level of risk for prostate cancer — age 40 for men
at very high risk; age 50 for men of average risk.4
Males living below the poverty level are less likely to get screened for prostate cancer than their wealthier
counterparts.7 Males without insurance or with Medicaid experience later-stage prostate cancer diagnoses compared to patients with private insurance.4 Access to affordable and equitable health insurance and health care services is important for early detection and appropriate treatment of this disease.
Data Sources: Prostate Cancer
tables
Tables 1-3: Data presented for Hispanics include Hispanic residents of any race. Data presented for whites, Asians/
Pacific Islanders and African Americans/blacks include non-Hispanic residents. Not all races/ethnicities are shown but
all are included in totals for the county, by gender and by city. Counts fewer than five are not shown in order to protect
anonymity. Rates were not calculated for any group with fewer than 20 cases due to unstable estimates.
Tables 1-2: These tables include total deaths and age-adjusted average annual death rates per 100,000 residents for 2005
through 2007. Mortality data from the California Department of Public Health (CDPH), www.cdph.ca.gov/, Center for
Health Statistics’ Death Statistical Master File, 2005-2007. Any analyses or interpretations of the data were reached by the
Community Health Assessment, Planning and Evaluation (CHAPE) Unit of Contra Costa Health Services and not the
CDPH.
ICD10 coding for malignant neoplasm of the prostate (ICD C61) from the Centers for Disease Control and Prevention
National Center for Health Statistics, available online at: http://www.cdc.gov/nchs/data/nvsr/nvsr50/nvsr50_16.pdf.
Population estimates for Contra Costa and its subpopulations (by age, gender, race/ethnicity, city/census place) for
2005-2007 were provided by the Urban Strategies Council, Oakland, CA. January, 2010. Data sources used to create
these estimates included: U.S. Census 2000, Neilsen Claritas 2009, Association of Bay Area Governments (ABAG) 2009
Projections, and California Department of Finance Population Estimates for Cities, Counties and the State 2001-2009,
with 2000 Benchmark.
California population estimate for state level rate from the State of California, Department of Finance, E-4 Population
Estimates for Cities, Counties and the State, 2001–2009, with 2000 Benchmark. Sacramento, California, May 2009.
Healthy People 2010 objectives from the US Department of Health and Human Services’ Office of Disease Prevention and
Health Promotion, available online at http://www.healthypeople.gov/
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CHRONIC DISEASES
Table 3: This table includes five-year case counts and age-adjusted average annual new case rates per 100,000 residents
for 2003 through 2007. New case data from the California Cancer Registry. (2009). Cancer Incidence Rates in California.
Based on October 2009 Quarterly Extract (Released October 08, 2009). Retrieved (12/14/09) from
http://www.cancer-rates.info/ca.
Note: Veterans Health Administration (VHA) hospitals did not report cancer cases to the California Cancer Registry
(CCR) in 2005, 2006 and 2007. Therefore, new case counts and rates for adult males for 2005–2007 are underestimates and
should be interpreted with caution. Although there is no way to know how many unreported cancer cases were diagnosed
in these facilities, historically VHA-reported cases have accounted for approximately 4% of all new male cancers reported
to the CCR. (For information in the undercount see www.ccrcal.org/publications/Vatechnotes).
International Classification of Diseases for Oncology, Third Edition (ICD-O-3) coding for new prostate cancer cases:
C619, excluding histology types excluding 9590-9989, and sometimes 9050-9055, 9140+; recode 28010. (For information
on ICD-O-3 codes see: http://seer.cancer.gov/siterecode/icdo3_d01272003/). Note: This section includes data for invasive
cancer only. All but two new prostate cancer cases reported to the California Cancer Registry for this period were invasive
cancer.
Text
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5.
6.
7.
National Cancer Institute. (n.d.) Cancer Topics: Prostate Cancer. Retrieved on June 12, 2010 from:
http://www.cancer.gov/cancertopics/types/prostate
California Cancer Registry. (2009) Incidence data for 2003–07, based on October 2009 Quarterly Extract, released
October 08, 2009.
California Department of Public Health, Center for Health Statistics’ Death Statistical Master File, 2005–2007.
American Cancer Society. (2010) Cancer Facts & Figures 2010. Atlanta: American Cancer Society.
U.S. Cancer Statistics Working Group. (2010) United States Cancer Statistics: 1999–2006 Incidence and Mortality
Web-based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and
Prevention and National Cancer Institute. Data for 2006 retrieved August 31, 2010 at: www.cdc.gov/uscs.
Morris CR, Epstein J, Nassere K, Hofer BM, Rico J, Bates JH, Snipes KP. (2010) Trends in Cancer Incidence,
Mortality, Risk Factors and Health Behaviors in California. Sacramento, CA: California Department of Public Health,
Cancer Surveillance Section, January 2010.
American Cancer Society, California Department Public Health, California Cancer Registry (2009). California
Cancer Facts and Figures 2010. Oakland, CA: American Cancer Society, California Division, September 2009.
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